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Factors influencing breast cancer-related lymphedema volume after intensive decongestive physiotherapy
Background Lymphedema treatment is based on an intensive decongestive physiotherapy phase of volume reduction followed by a long-term maintenance phase. Factors influencing the morbid lymphedema volume increase during maintenance were analyzed. Materials and methods Among 867 consecutive women recru...
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| Published in: | Supportive care in cancer 2011-07, Vol.19 (7), p.935-940 |
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| container_title | Supportive care in cancer |
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| creator | Vignes, Stéphane Porcher, Raphaël Arrault, Maria Dupuy, Alain |
| description | Background
Lymphedema treatment is based on an intensive decongestive physiotherapy phase of volume reduction followed by a long-term maintenance phase. Factors influencing the morbid lymphedema volume increase during maintenance were analyzed.
Materials and methods
Among 867 consecutive women recruited and followed in a single lymphology unit, 682 were analyzed. The other 185 were not analyzed because of an initial lymphedema volume |
| doi_str_mv | 10.1007/s00520-010-0906-x |
| format | article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_871001083</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A358058213</galeid><sourcerecordid>A358058213</sourcerecordid><originalsourceid>FETCH-LOGICAL-c437t-bd6dda03ae394497f1081b3773929f69366e38352aba8a561502eceae5d22b753</originalsourceid><addsrcrecordid>eNp1Uc1u1DAYtBCILgsPwAVFcOCU4t84PlZVS5EqcYGz5ThfdlMlcbCdqvv2_aIUEAhkWZbtmfF4hpC3jJ4zSvWnRKnitKQMp6FV-fCM7JgUotRCmOdkR41kpRRKnZFXKd1RyrRW_CU541QaZWqxI9218znEVPRTNyww-X46FE0El3Lh3eQhlhEGl6EthtM4H6GF0RX3YVhGKFyXISIzw5T6eyha8GE6QMrrZj6eUh_yEaKbT6_Ji84NCd48rXvy_frq2-VNefv185fLi9vSS6Fz2bRV2zoqHAgjpdEdozVrhNbCcNNVRlQViFoo7hpXO1UxRTl4cKBazhutxJ583HTnGH4s6MSOffIwDG6CsCRbawwORQUi3_-FvAtLnNAcgqiU2uBze_JhAx3cABYjCjk6v0raC6FqqmrOVqnzf6BwYFY9JgJdj-d_ENhG8DGkFKGzc-xHF0-WUbs2a7dmLVq1a7P2ATnvnvwuzQjtL8bPKhHAN0DCK2wh_v7Q_1UfAdpirog</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>870447969</pqid></control><display><type>article</type><title>Factors influencing breast cancer-related lymphedema volume after intensive decongestive physiotherapy</title><source>Social Science Premium Collection</source><source>Springer Nature</source><source>Sociology Collection</source><creator>Vignes, Stéphane ; Porcher, Raphaël ; Arrault, Maria ; Dupuy, Alain</creator><creatorcontrib>Vignes, Stéphane ; Porcher, Raphaël ; Arrault, Maria ; Dupuy, Alain</creatorcontrib><description>Background
Lymphedema treatment is based on an intensive decongestive physiotherapy phase of volume reduction followed by a long-term maintenance phase. Factors influencing the morbid lymphedema volume increase during maintenance were analyzed.
Materials and methods
Among 867 consecutive women recruited and followed in a single lymphology unit, 682 were analyzed. The other 185 were not analyzed because of an initial lymphedema volume <250 ml, <20% lymphedema volume decrease during the intensive phase, or they were lost to follow-up. Lymphedema volume was recorded prior to and at the end of intensive phase, and at each follow-up visit. During follow-up, treatment failure was defined as a lymphedema volume increase of ≥50% of the total reduction obtained during the intensive phase.
Results
Median lymphedema volume was 936 ml before and 335 ml after intensive decongestive physiotherapy (
P
< 0.0001). Median follow-up was 28 months. During the maintenance phase, the risk of treatment failure at 1, 2, and 4 years was estimated to be 38.1%, 53.1%, and 64.8%, respectively. Wearing an elastic sleeve during the day and an overnight multilayer low-stretch bandage (median, four nights per week; interquartile range, 2–6) significantly decreased the risk of treatment failure [hazard ratio, 0.53, (0.34–0.82),
P
= 0.004], whereas manual lymph drainage adjunction to those therapeutic components did not. The risk of treatment failure was also associated with weight and body mass index at inclusion.
Conclusion
Risk of maintenance-therapy failure after intensive decongestive physiotherapy was associated with patients characteristics (younger age, higher weight, and body mass index), while elastic sleeve and bandage were associated with better maintenance results. Paradoxical effect of manual lymph drainage is likely to be related to indication bias.</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-010-0906-x</identifier><identifier>PMID: 20495983</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Aged ; Analysis ; Breast cancer ; Breast Neoplasms - complications ; Breast Neoplasms - psychology ; Breast Neoplasms - therapy ; Clinical outcomes ; Confidence Intervals ; Drainage ; Female ; Health aspects ; Health Status Indicators ; Humans ; Lymphatic system ; Lymphedema ; Lymphedema - etiology ; Lymphedema - pathology ; Medical treatment ; Medicine ; Medicine & Public Health ; Middle Aged ; Nursing ; Nursing Research ; Oncology ; Original Article ; Pain Medicine ; Physical therapy ; Physical Therapy Modalities - instrumentation ; Postoperative Complications - etiology ; Postoperative Complications - pathology ; Prospective Studies ; Rehabilitation Medicine ; Risk Factors ; Statistics as Topic ; Stockings, Compression ; Therapeutics, Physiological</subject><ispartof>Supportive care in cancer, 2011-07, Vol.19 (7), p.935-940</ispartof><rights>Springer-Verlag 2010</rights><rights>COPYRIGHT 2011 Springer</rights><rights>Springer-Verlag 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-bd6dda03ae394497f1081b3773929f69366e38352aba8a561502eceae5d22b753</citedby><cites>FETCH-LOGICAL-c437t-bd6dda03ae394497f1081b3773929f69366e38352aba8a561502eceae5d22b753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/870447969/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/870447969?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,21375,21376,27905,27906,33592,33593,34511,34512,43714,44096,73970,74388</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20495983$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vignes, Stéphane</creatorcontrib><creatorcontrib>Porcher, Raphaël</creatorcontrib><creatorcontrib>Arrault, Maria</creatorcontrib><creatorcontrib>Dupuy, Alain</creatorcontrib><title>Factors influencing breast cancer-related lymphedema volume after intensive decongestive physiotherapy</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Background
Lymphedema treatment is based on an intensive decongestive physiotherapy phase of volume reduction followed by a long-term maintenance phase. Factors influencing the morbid lymphedema volume increase during maintenance were analyzed.
Materials and methods
Among 867 consecutive women recruited and followed in a single lymphology unit, 682 were analyzed. The other 185 were not analyzed because of an initial lymphedema volume <250 ml, <20% lymphedema volume decrease during the intensive phase, or they were lost to follow-up. Lymphedema volume was recorded prior to and at the end of intensive phase, and at each follow-up visit. During follow-up, treatment failure was defined as a lymphedema volume increase of ≥50% of the total reduction obtained during the intensive phase.
Results
Median lymphedema volume was 936 ml before and 335 ml after intensive decongestive physiotherapy (
P
< 0.0001). Median follow-up was 28 months. During the maintenance phase, the risk of treatment failure at 1, 2, and 4 years was estimated to be 38.1%, 53.1%, and 64.8%, respectively. Wearing an elastic sleeve during the day and an overnight multilayer low-stretch bandage (median, four nights per week; interquartile range, 2–6) significantly decreased the risk of treatment failure [hazard ratio, 0.53, (0.34–0.82),
P
= 0.004], whereas manual lymph drainage adjunction to those therapeutic components did not. The risk of treatment failure was also associated with weight and body mass index at inclusion.
Conclusion
Risk of maintenance-therapy failure after intensive decongestive physiotherapy was associated with patients characteristics (younger age, higher weight, and body mass index), while elastic sleeve and bandage were associated with better maintenance results. Paradoxical effect of manual lymph drainage is likely to be related to indication bias.</description><subject>Aged</subject><subject>Analysis</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - complications</subject><subject>Breast Neoplasms - psychology</subject><subject>Breast Neoplasms - therapy</subject><subject>Clinical outcomes</subject><subject>Confidence Intervals</subject><subject>Drainage</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health Status Indicators</subject><subject>Humans</subject><subject>Lymphatic system</subject><subject>Lymphedema</subject><subject>Lymphedema - etiology</subject><subject>Lymphedema - pathology</subject><subject>Medical treatment</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Physical therapy</subject><subject>Physical Therapy Modalities - instrumentation</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - pathology</subject><subject>Prospective Studies</subject><subject>Rehabilitation Medicine</subject><subject>Risk Factors</subject><subject>Statistics as Topic</subject><subject>Stockings, Compression</subject><subject>Therapeutics, Physiological</subject><issn>0941-4355</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>ALSLI</sourceid><sourceid>HEHIP</sourceid><sourceid>M2R</sourceid><sourceid>M2S</sourceid><recordid>eNp1Uc1u1DAYtBCILgsPwAVFcOCU4t84PlZVS5EqcYGz5ThfdlMlcbCdqvv2_aIUEAhkWZbtmfF4hpC3jJ4zSvWnRKnitKQMp6FV-fCM7JgUotRCmOdkR41kpRRKnZFXKd1RyrRW_CU541QaZWqxI9218znEVPRTNyww-X46FE0El3Lh3eQhlhEGl6EthtM4H6GF0RX3YVhGKFyXISIzw5T6eyha8GE6QMrrZj6eUh_yEaKbT6_Ji84NCd48rXvy_frq2-VNefv185fLi9vSS6Fz2bRV2zoqHAgjpdEdozVrhNbCcNNVRlQViFoo7hpXO1UxRTl4cKBazhutxJ583HTnGH4s6MSOffIwDG6CsCRbawwORQUi3_-FvAtLnNAcgqiU2uBze_JhAx3cABYjCjk6v0raC6FqqmrOVqnzf6BwYFY9JgJdj-d_ENhG8DGkFKGzc-xHF0-WUbs2a7dmLVq1a7P2ATnvnvwuzQjtL8bPKhHAN0DCK2wh_v7Q_1UfAdpirog</recordid><startdate>20110701</startdate><enddate>20110701</enddate><creator>Vignes, Stéphane</creator><creator>Porcher, Raphaël</creator><creator>Arrault, Maria</creator><creator>Dupuy, Alain</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20110701</creationdate><title>Factors influencing breast cancer-related lymphedema volume after intensive decongestive physiotherapy</title><author>Vignes, Stéphane ; Porcher, Raphaël ; Arrault, Maria ; Dupuy, Alain</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-bd6dda03ae394497f1081b3773929f69366e38352aba8a561502eceae5d22b753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Analysis</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - complications</topic><topic>Breast Neoplasms - psychology</topic><topic>Breast Neoplasms - therapy</topic><topic>Clinical outcomes</topic><topic>Confidence Intervals</topic><topic>Drainage</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health Status Indicators</topic><topic>Humans</topic><topic>Lymphatic system</topic><topic>Lymphedema</topic><topic>Lymphedema - etiology</topic><topic>Lymphedema - pathology</topic><topic>Medical treatment</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Physical therapy</topic><topic>Physical Therapy Modalities - instrumentation</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - pathology</topic><topic>Prospective Studies</topic><topic>Rehabilitation Medicine</topic><topic>Risk Factors</topic><topic>Statistics as Topic</topic><topic>Stockings, Compression</topic><topic>Therapeutics, Physiological</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vignes, Stéphane</creatorcontrib><creatorcontrib>Porcher, Raphaël</creatorcontrib><creatorcontrib>Arrault, Maria</creatorcontrib><creatorcontrib>Dupuy, Alain</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection【Remote access available】</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Social Science Database (ProQuest)</collection><collection>Sociology Database (ProQuest)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vignes, Stéphane</au><au>Porcher, Raphaël</au><au>Arrault, Maria</au><au>Dupuy, Alain</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors influencing breast cancer-related lymphedema volume after intensive decongestive physiotherapy</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2011-07-01</date><risdate>2011</risdate><volume>19</volume><issue>7</issue><spage>935</spage><epage>940</epage><pages>935-940</pages><issn>0941-4355</issn><eissn>1433-7339</eissn><abstract>Background
Lymphedema treatment is based on an intensive decongestive physiotherapy phase of volume reduction followed by a long-term maintenance phase. Factors influencing the morbid lymphedema volume increase during maintenance were analyzed.
Materials and methods
Among 867 consecutive women recruited and followed in a single lymphology unit, 682 were analyzed. The other 185 were not analyzed because of an initial lymphedema volume <250 ml, <20% lymphedema volume decrease during the intensive phase, or they were lost to follow-up. Lymphedema volume was recorded prior to and at the end of intensive phase, and at each follow-up visit. During follow-up, treatment failure was defined as a lymphedema volume increase of ≥50% of the total reduction obtained during the intensive phase.
Results
Median lymphedema volume was 936 ml before and 335 ml after intensive decongestive physiotherapy (
P
< 0.0001). Median follow-up was 28 months. During the maintenance phase, the risk of treatment failure at 1, 2, and 4 years was estimated to be 38.1%, 53.1%, and 64.8%, respectively. Wearing an elastic sleeve during the day and an overnight multilayer low-stretch bandage (median, four nights per week; interquartile range, 2–6) significantly decreased the risk of treatment failure [hazard ratio, 0.53, (0.34–0.82),
P
= 0.004], whereas manual lymph drainage adjunction to those therapeutic components did not. The risk of treatment failure was also associated with weight and body mass index at inclusion.
Conclusion
Risk of maintenance-therapy failure after intensive decongestive physiotherapy was associated with patients characteristics (younger age, higher weight, and body mass index), while elastic sleeve and bandage were associated with better maintenance results. Paradoxical effect of manual lymph drainage is likely to be related to indication bias.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>20495983</pmid><doi>10.1007/s00520-010-0906-x</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Analysis Breast cancer Breast Neoplasms - complications Breast Neoplasms - psychology Breast Neoplasms - therapy Clinical outcomes Confidence Intervals Drainage Female Health aspects Health Status Indicators Humans Lymphatic system Lymphedema Lymphedema - etiology Lymphedema - pathology Medical treatment Medicine Medicine & Public Health Middle Aged Nursing Nursing Research Oncology Original Article Pain Medicine Physical therapy Physical Therapy Modalities - instrumentation Postoperative Complications - etiology Postoperative Complications - pathology Prospective Studies Rehabilitation Medicine Risk Factors Statistics as Topic Stockings, Compression Therapeutics, Physiological |
| title | Factors influencing breast cancer-related lymphedema volume after intensive decongestive physiotherapy |
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